Individual
THOMAS J RENALDO
Active
Individual
THOMAS J RENALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS005407L
PA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
OS005407L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040725000
KEYSTONE EAST
PA
01
—
138086
HIGHMARK BLUE SHIELD
PA
01
—
50004441
CAPITAL BLUE CROSS
PA
01
—
80095184
RAILROAD MEDICARE
PA
Enumeration date
06/06/2006
Last updated
04/10/2019
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